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General NPI Number Information
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NPI Number | 1881675239
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Entity Type | Organization
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Legal Business Name | ATLANTIC KIDNEY CENTERS INC
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4700 N CONGRESS AVE STE 104
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-3282
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Country | US
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Telephone | 561-845-2888
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Fax | 561-845-7282
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Provider Business Mailing Address
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Address Line | 4700 N CONGRESS AVE STE 104
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-3282
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Country | US
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Telephone | 561-845-2888
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Fax | 561-845-7282
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MARIETTA HOLMES
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Credential |
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Telephone | 561-845-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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